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The exact timing of these nAb responses and their relation to viral evolution is still poorly characterized, as it is now established that the viral quasispecies will have already evolved from the original T/F within 100 days post infection, this raises the question as to whether the earliest responses specifically target the T/F virus 9,10,16,19

Kauser S, Schallreuter KU, Thody AJ, Gummer C, Tobin DJ

It is intriguing though, that despite the mild impact on L-carnitine levels, patients affected by these diseases have marked brain alterations such as nondysmorphic autism (deficiency of 6- N -trimethyllysine dioxygenase) [60] and microcephaly and speech delay (deficiency of -butyrobetaine dioxygenase) [61]
